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A Weekly Health Policy Round Up From Health Affairs            

**January 12, 2020**

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IN THE JOURNAL

NEW ISSUE:
PATIENT COSTS, BUNDLED PAYMENT & MORE

The January issue of

**Health Affairs**covers topics such as the costs patients face when
they receive care and the effects of the expansion of Medicaid
eligibility as part of the Affordable Care Act (ACA).   

Read the January 2020 table of contents
.

L
isten
to a two-minute introduction of the issue from Editor-in-Chief Alan
Weil.

Read "From the Editor in Chief."

MATERNAL & CHILD HEALTH

Out-Of-Pocket Spending For Maternity Care Among Women With
Employer-Based Insurance, 2008-15

By Michelle H. Moniz, A. Mark Fendrick, Giselle E. Kolenic, Anca Tilea,
Lindsay K. Admon, and Vanessa K. Dalton

While maternity care is a required benefit under the ACA, women with
employer-based insurance still face deductibles and copayments when
obtaining care. Michelle Moniz and coauthors find that between 2008 and
2015, mean out-of-pocket spending for maternity care for these women
increased from $3,069 to $4,569, driven mostly by increases in
deductibles. Read More >>

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PAYMENT

Differences Between Public And Private Hospital Payment Rates Narrowed,
2012-16

By Thomas M. Selden

In an earlier study Tom Selden and coauthors used data from the Medical
Expenditure Panel Survey (MEPS) to show that the average difference in
payment rates for inpatient hospital stays between private insurance and
Medicare grew from under 10 percent in 2000 to about 75 percent in 2012.
This DataWatch updates those results through 2016, revealing a slowing
in and even a reversal of the divergence between private and public
(Medicare and Medicaid) payment rates. Read More >>

AFFORDABLE CARE ACT

Terminating Cost-Sharing Reduction Subsidy Payments: The Impact Of
Marketplace Zero-Dollar Premium Plans On Enrollment

By Coleman Drake and David M. Anderson

The termination of cost-sharing reduction subsidy payments to insurers
in 2017 resulted in a proliferation of Marketplace plans having
zero-dollar premiums in 2018 and 2019. In this study Coleman Drake and
David Anderson examined whether a zero-price effect exists in potential
enrollees' decisions to become insured in the Marketplaces. Read More
>>

HEALTH REFORM

Medicare For All: An Analysis Of Key Policy Issues

By Micah Johnson, Sanjay Kishore, and Donald M. Berwick

Micah Johnson and coauthors identify key policy design issues for a
Medicare for All system: comprehensiveness of coverage, the private
sector's role, the payment approach, and financing. Read More >>

Challenges To Medicare For All Remain Daunting

By Austin B. Frakt and Jonathan Oberlander

Medicare for All will not become viable unless it can meet the daunting
political, economic, and administrative realities that govern US health
care. Austin Frakt and Jonathan Oberlander explore several key issues.
Read More >>

MEDICAID

Medicaid Expansion Slowed Rates Of Health Decline For Low-Income Adults
In Southern States

By John A. Graves, Laura A. Hatfield, William Blot, Nancy L. Keating,
and J. Michael McWilliams

John Graves and coauthors draw upon survey data collected from health
center patients in southern states to compare outcomes in four states
that expanded Medicaid with those in eight states that did not. Read
More >>

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THIS WEEK ON THE BLOG

FOLLOWING THE ACA

Will The Supreme Court Take Up The Contraceptive Mandate (Again)?

By Katie Keith (1/7/20)

We may learn the Supreme Court's decision on January 13, 2020. This is
because

**Pennsylvania**has been scheduled for the Court's conference on
January 10. If the Court accepts the appeal, it could affirm or reverse
the Third Circuit's decision. If not, the case would be over, and the
Third Circuit's decision would be allowed to stand. The Trump-era
rules on the contraceptive mandate would be permanently vacated and
unenforceable.
Read More >>

Democratic AGs, House Ask Supreme Court For Expedited Review Of Texas

By Katie Keith (1/6/20)

Expedited review and a resolution of the case in 2020 is necessary, the
House and Democratic attorneys general maintain, to address the
uncertainty that Texas creates about the future of the ACA and the
potential for devastating consequences for the health care system if a
lower court decision is upheld. Read More >>

ACCOUNTABLE CARE

Number Of ACOs Taking Downside Risk Doubles Under 'Pathways To
Success'

By Seema Verma (1/10/20)

Our redesign of the Medicare Shared Savings Program, "Pathways to
Success," puts accountable care organizations (ACOs) on a quicker path
to taking on real risk, with accountability for spending increases
generally required after two years for new ACOs, while closely
monitoring the quality of care provided. Read More >>

How Are ACOs Prioritizing Palliative Care And Other Serious Illness
Strategies?

By Rachel Roiland, William K. Bleser, David Muhlestein, Robert S.
Saunders (1/7/20)

Given their breadth and their incentives for care coordination,
accountable care organizations could be a powerful vehicle for improving
palliative and serious illness care. Read More >>

PHARMACEUTICALS AND MEDICAL INNOVATION

Prescription Drug Policy: The Year in Review, And the Year Ahead

By Rachel Sachs (1/6/20)

This past year, prescription drug policy issues remained at the
forefront of the national health policy conversation. In this post, I
review five of the biggest prescription drug policy developments of 2019
(and revisit my predictions from my January 3, 2019, post) and offer
five issues to watch for in 2020. Read More >>

LEGAL AND REGULATORY ISSUES

The New State Medical Board: Life In The Antitrust Shadow

By Eli Y. Adashi, Barak D. Richman, and Reuben C. Baker (1/6/20)

The new State Medical Board

could be one that abandons its role as an ossified gatekeeper and crafts
a visionary role for expanding consumer welfare and professional
dynamism. Read More >>

MEDICARE

Will Medicare For All Get Us To Value?

By David Lansky (1/10/20)

Let's begin the debate on how we want our health care system to look,
what we hold it accountable for, and the value we place on improved
health outcomes and affordability versus industry and professional
economic interests. Read More >>

SYSTEMS OF CARE

Moving To A Learning Measurement System

By Somava Stout, Christine Petrin, and Karen DeSalvo (1/8/20)

We need a national measurement system that can bridge sectors to advance
health, well-being, and equity. Read More >>

PAYMENT

Patient Influencers, Paid By Pharmaceutical Companies, Should Be
Required To Disclose Industry Ties

By Judy Butler and Adriane Fugh-Berman (1/10/20)

Transparency is a minimum standard for assessing whose views should
carry most weight in public health debates. Read More >>

MEDICAID

Proposed Rules On Medicaid Financing Miss Mark And Threaten Access

By Cindy Mann and Anne O'Hagen Karl (1/8/20)

If finalized, the rules would have a profound impact on state financing
and payment policies that, in turn, could dramatically reduce
beneficiary access to care. Read More >>

ACCESS TO CARE

Resolving Wait Times With Cross-Specialty Collaboration

By Benjamin F. Chong (1/9/20)

Dermatology intersects with many other specialties because the skin is
the body's largest organ and can serve as a window into internal
conditions. Read More >>

MATERNAL & CHILD HEALTH

The Next Steps To Advance Maternal And Child Health In Medicaid: Filling
Gaps In Postpartum Coverage And Newborn Enrollment

By Kay Johnson, Sara Rosenbaum, and Morgan Handley (1/9/20)

Medicaid policy changes at the federal level and action by states to
support maternal and infant health could make a tremendous difference in
the lives of half of all infants and their mothers throughout the
nation. Read More >>

COSTS & SPENDING

Disappointing Randomized Controlled Trial Results Show A Way Forward On
Complex Care In Camden And Beyond

By Kathleen Noonan (1/9/20)

Like medicine itself, the work of caring for our nation's most
vulnerable people is neither simple to do nor easy to measure. Read More
>